Archived: Lynwood Residential Care Home

Updated 20 April 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 23 February 2015 and was unannounced. We made an announced visit to the home on 24 February to continue the inspection. The service met all of the regulations we inspected against at our last inspection on 27 October 2014.

The inspection was carried out by two inspectors. Before we visited the home we reviewed information that we held about the service and the service provider which included incident notifications they had sent us. We also contacted relevant professionals, clinicians and appropriate authorities to obtain their views about the care provided at the home. We did not send the provider a Provider Information Return (PIR). This is a form that asks the provider to give us some key information about the service, what the service does well and improvements they plan to make.

Some of the people living in the home were unable to give their verbal opinion about the care and support they received. Therefore we used a short observational framework for inspection (SOFI). This is a tool used by CQC inspectors to capture the experiences of people who use services who may not be able to express this for themselves. During the inspection we saw how the staff interacted with people using the service, and observed staff delivering care and support in communal areas of the home.

We spoke with eight people living at the home, two relatives, one visitor, one chef, one domestic assistant, five health care assistants (HCA) and the providers. We looked at the hairdressing room, the kitchen, the basement laundry and food store, a selection of bedrooms and communal areas.

We reviewed records about people’s care which included the care records for four people and the medicine records for all of the people who used the service.

We also looked at seven staff files including supervision records and a sample of records relating to how the home was managed. During the inspection we saw how the staff interacted with people using the service. We also observed care and support in communal areas.

Updated 20 April 2015

This was an unannounced inspection.

A registered manager is in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The home is registered to provide residential care and accommodation for up to 23 older people. There were 21 people living at the home when we visited. Accommodation was on three floors which could be accessed via stairs or a passenger lift. Accommodation was provided in single bedrooms although there was one shared room for two people. Four rooms had an en suite toilet facility and of those, one room had an en suite bath. There were three communal areas that supported people spending time together including a communal dining room. There was a large garden to the rear of the property and an off road car park at the front of the property.

People spoke positively about staff and we saw relationships between individual staff and people using the service was warm, compassionate and caring and staff showed empathy in their approach.

There was a daily planned group activity for people and opportunities for people to pursue their own hobbies or go out independently with assistance. People told us they knew how to make a complaint.

Medicines were stored, administered and returned safely and records were kept for medicines received and disposed of, this included controlled drugs (CD’s).

People told us they enjoyed the food, and choices were always available. We saw people’s nutrition and hydration needs being met. We found that people’s healthcare was delivered consistently by staff. The service supported people to access the community to prevent them from being isolated

The provider did not have an effective pre admission procedure. Risks to people were not mitigated because some people had not received an assessment from when they began to use the service. Staff knew how to monitor people’s health and make sure they had enough to eat and drink.

Recruitment checks were carried out to protect people from the risk of employing unsuitable staff.

Some staff were concerned that not enough staff were trained in certain areas and had not received an induction at the start of their employment. Records showed three staff had not received up to date mandatory and refresher training including training about whistleblowing.

The manager and staff team did not have a clear understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and were not always following the MCA for people who lacked capacity to make a decision.

The provider had not made an application under the MCA and DoLS for people, even though their liberty was being restricted under the Mental Health Act (MHA) 2007. The correct safeguarding procedures were in place.

There were no systems in place to effectively monitor the quality of the service or drive improvements forward. The manager communicated with staff daily to discuss and share good practice.

Not all risk assessments clearly stated how risks would be managed because they had not been fully completed. Some first floor bedroom windows and inappropriately placed furniture and equipment, did not promote people’s safety and wellbeing.

Door locks were not fitted to bathroom and toilet doors and did not uphold the privacy, dignity and independence of people who used the service.

A system of maintaining appropriate standards of cleanliness and hygiene was not being followed regularly.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.You can see what action we told the provider to take at the back of the full version of the report.